Helix wire osteosynthesis of proximal humerus fractures: unacceptably high rate of failure.

The aim of this study was to assess the success rate of osteosynthesis of proximal humerus fractures with titanium helix wires. We retrospectively reviewed the charts of 37 patients who underwent fixation with a helix wire after fracture of the proximal humerus from June 2003 till June 2006. Three patients were excluded because of insufficient details of admission and follow-up. Median age was 64 years (range: 22 to 89). Fractures were classified according to Neer's classification: there were two 3-fragment fractures, thirty 2-fragment fractures and two undisplaced fractures. Internal fixation was performed on average 2.5 days after trauma. During operation either one (18) or two (16) helix wires were used depending on fracture stability. Postoperative immobilisation included approximately 2 weeks in a fixed arm sling and 2 weeks in a collar and cuff. First follow-up was at an average of 2.3 weeks and final follow-up at 14.8 weeks. Follow-up included both radiological and clinical assessment. Already at first follow-up 7 (20%) fractures were displaced, and further surgery was indicated. At final follow-up 9 more fractures were labelled as failures. There was an overall failure rate of 47%. Although helix wire osteosynthesis is a less invasive surgical technique, a failure rate of 47% overshadows the effectiveness of this method. We do not recommend this method for treatment of proximal humeral fractures.